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Antibiotics before dental with heart murmur

Hi, I wanted to get other opinions on giving antibiotics before and after a dental to my cavalier with a heart murmur. My 6.5 year old sweet boy was diagnosed in February 2012 with a grade 2 and now this past February it was graded as a 3. Both visits were graded by echo from a board certified cardiologist.

I just switched vets last week and my new vet says studies now show that it is not necessary to treat with antibiotics as a caution for dogs with heart murmurs. So I then contacted my dog's:cardiologist who told me this:

"In humans, the current recommendation is not to administer antibiotics prior to a dental procedure in an effort to prevent endocarditis. Antibiotics may be helpful in calming down gingivitis, but the bacteria usually associated with endocarditis are not the ones commonly used for that purpose. It is one of those things that vets have done for years with no scientific proof that it makes a difference."

Last year he had 5 teeth extracted, and was put on Clavamox 5 days before dental and 5 days after. I also did monthly pulse therapy of Clindamycin, which did not help much. This year he does have some loose front teeth. His teeth are not stained, it is more a problem of gingivitis. I do brush his teeth and he gets a greenie everyday after he eats. He is just prone to red gums. I also give him a fish oil capsule along with a 50 mg capsule of COQ10. He is not on any heart meds as of yet.

Reading your post has made my day!!! Your new vet and your cardiologist are absolutely correct, and you are lucky to have clinicians who obviously keep up to date on the latest research.

I had a private email conversation with Rod and Karlin some time back about this, and I thought about posting on the various message boards about this but did not. All of the current research shows that dental disease does not CAUSE heart disease. The huge study that everyone quotes done by Glickman at Purdue is terribly flawed and made incorrect conclusions. (It's true that many (most?) small breed, elderly dogs have dental disease AND degenerative valvular disease - however, dental disease does not cause or worsen heart disease. And there is no evidence that endocarditis (infection of the heart valves) is caused by dental disease or dental cleanings. Unfortunately, Glickman's study was widely publicized and now most people think incorrectly that dental disease causes or worsens heart disease. I have a huge document that I compiled with quotes from leading cardiologists who all came to this conclusion; unfortunately no one publicized the updated information so most GP vets and pet owners don't know the current thinking on the subject.

Incidentally, there is no relationship between endocardiosis and endocarditis - these are two completely different types of heart disease with different causes and if a dog has one disease, it is not more likely to develop the other disease.

And - just because dental disease does not cause or worsen heart disease, I am still a huge believer in regular dental cleanings for my dogs because of the many other benefits. My 13, 10, and 5 year old dogs all just had dentals in February.

FWIW As a teenager I had rheumatic fever that damaged my mitral valve. From that time on antibiotics were taken prior to every dental appointment when scaling took place. If you recall the singer Bobby Darren had heart valves damage from a young age and died because he wasn't pre-medicated prior to a dental procedure. So I've often wondered about dogs with mitral valve problems. Maybe dog valves don't need an infection to cause them to fail.

Setting aside the issue of heart disease and antibiotics, this is a breed that seems genetically more prone to gum disease and poor teeth. Whatever the case, gum disease and rotting or very worn teeth are as painful to dogs as they are to humans. Dentals are a good way to keep some of this under control and make sure our dogs are not living with considerable pain and discomfort. I would tend to believe that oral pain is probably the single most likely, and typically, left untreated, form of chronic pain our dogs of any breed can have (perhaps excepting arthritis as they age).